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European Society of Cardiology: Vaping must be included in the next EU smoking ban

The ESC supports the Council Recommendations on smoke- and aerosol-free environments

Preventive Cardiology
Brussels, 26 November 2024: In view of tomorrow’s (27 November) debate in the European Parliament on the Council Recommendations on smoke and aerosol-free environments, the European Society of Cardiology (ESC) expresses its strong support for the approval of the Recommendations as they were proposed.  
 
The Recommendations will update a framework provided in 2009 to EU member states, aiming to protect citizens - particularly vulnerable groups - against the risks posed by second-hand smoke in public spaces. 
The ESC supports the overarching goals of the Recommendations: to extend the current framework to include certain outdoor spaces, and to extend its restrictions to second-hand emissions originating from emerging products emitting smoke or aerosols.  
 
"Scientific evidence unequivocally demonstrates that vaping poses significant health risks. To protect European children and adolescents from a potential epidemic of addiction, we are calling on policymakers to implement stringent regulations on e-cigarettes or consider banning them altogether," Professor Susanna Price, ESC Advocacy Committee Chair says.    
 
These measures are crucial to advancing public health and addressing the rising use of emerging products whose harmful effects on human health are still to be quantified. This is particularly essential in consideration of the notable uptake of such products among younger generations worldwide and aligns with the goal of achieving a tobacco-free generation by 2040 established by the EU Beating Cancer Plan.  
 
The ESC highlights several factors that should convince policymakers to support the Recommendations: 
 
  1. Smoking and vaping are harmful: the harms of smoking and vaping are well-documented, as is their impact on cardiovascular health. Tobacco smoke increases the risk of death from cardiovascular disease up to three times [1], and smoking remains one of the most preventable causes of cardiovascular-related deaths worldwide [2]. For emerging products, available evidence demonstrates that inhaled aerosol containing nicotine has an acute impact on vascular and pulmonary functions [3] [4].  
  1. New products must be regulated carefully: the application of the precautionary principle to emerging products regulation aligns with the recommendations of the World Heart Federation to protect the general population from second-hand smoke of electronic cigarettes by prohibiting their use anywhere tobacco cigarettes have been banned [5]. Coherently, ESC experts have urged lawmakers to regulate e-cigarettes strongly or forbid their use, and to raise awareness of their potential adverse effects on human health until definitive evidence is available [6]. 
  1. The risks of vapes may outweigh their benefits: the popularity of emerging products among the youth, added to the risk of uptake of conventional cigarettes by children/youth using e-cigarettes, are not balanced by a clear positive effect of e-cigarettes on net smoking at population level [7].  

Considering these factors, the ESC expresses concern for the calls raised by some political parties and stakeholders to adopt a “harm reduction” approach, consisting in adopting lighter restrictions for emerging products. 
 
The ESC calls on lawmakers to adopt an evidence-based approach to this issue. Such an approach needs to be based on recommendations expressed by learned societies, which due to their mission and activities represent the primary source of independent and evidence-based knowledge concerning public health. To this aim, it recalls the Joint statement “European Societies call EU to Not Lose Momentum on Tobacco Policy” signed by the ESC, the European Respiratory Society, the European Cancer Organization and others, calling for policymakers to adopt the Recommendations as proposed by the Commission, and advocating for the revision of other laws such as the Tobacco Products Directive. 
 
In conclusion, the ESC calls on lawmakers to support these measures and to take decisive steps toward safeguarding public health for the current and future generations.  
 
ENDS 

Notes to editor

ESC Press Office 
Tel: +33 4 83 88 17 74 
Email: press@escardio.org 

Follow us on Twitter @ESCardioNews  

 

References: 

[1] ESC Cardiovascular Realities 2024 

[2] Magnussen, C., Ojeda, F. M., Leong, D. P., Alegre-Diaz, J., Amouyel, P., Aviles-Santa, L., De Bacquer, D., Ballantyne, C. M., Bernabé-Ortiz, A., Bobak, M., Brenner, H., Carrillo-Larco, R. M., De Lemos, J., Dobson, A., Dörr, M., Donfrancesco, C., Drygas, W., Dullaart, R. P., Engström, G., Blankenberg, S. (2023). Global effect of modifiable risk factors on cardiovascular disease and mortality. New England Journal of Medicine, 389(14), 1273–1285. https://doi.org/10.1056/nejmoa2206916 

[3] Antoniewicz, L., Brynedal, A., Hedman, L., Lundbäck, M., & Bosson, J. A. (2019). Acute effects of electronic cigarette inhalation on the vasculature and the conducting airways. Cardiovascular Toxicology, 19(5), 441–450. https://doi.org/10.1007/s12012-019-09516-x  

[4] Lyytinen, G., Brynedal, A., Anesäter, E., Antoniewicz, L., Blomberg, A., Wallén, H., Bosson, J. A., Hedman, L., Mobarrez, F., Tehrani, S., & Lundbäck, M. (2023). Electronic Cigarette Vaping with Nicotine Causes Increased Thrombogenicity and Impaired Microvascular Function in Healthy Volunteers: A Randomised Clinical Trial. Cardiovascular Toxicology, 23(7–8), 255–264. https://doi.org/10.1007/s12012-023-09802-9 

[5] Bianco, E., Skipalskyi, A., Goma, F., Odeh, H., Hasegawa, K., Zawawi, M. A., Stoklosa, M., Dalmau, R., Dorotheo, E. U., Berteletti, F., Mwangi, J., & Wang, Y. (2021). E-Cigarettes: a new threat to cardiovascular health – A World Heart Federation policy brief. Global Heart, 16(1). https://doi.org/10.5334/gh.1076  

[6] Kavousi, M., Pisinger, C., Barthelemy, J., De Smedt, D., Koskinas, K., Marques-Vidal, P., Panagiotakos, D., Prescott, E. B., Tiberi, M., Vassiliou, V. S., & Løchen, M. (2020). Electronic cigarettes and health with special focus on cardiovascular effects: position paper of the European Association of Preventive Cardiology (EAPC). European Journal of Preventive Cardiology, 28(14), 1552–1566. https://doi.org/10.1177/2047487320941993  

[7] Ibidem 

 

The ESC brings together healthcare professionals from more than 150 countries, working to advance cardiovascular medicine and help people to live longer, healthier lives.